Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis: A prospective randomized study

Yoon-Jung Boo, Wan-Bae Kim, Jong Han Kim, Taejin Song, S. Y. Choi, Y. C. Kim, S. O. Suh

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Abstract

Objective. Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of this study is to evaluate the influence of surgical trauma on systemic inflammation and the immune response in acute cholecystitis. Material and methods. Thirty-three patients with acute calculous cholecystitis were assigned to laparoscopic cholecystectomy (LC, n=18) or open cholecystectomy (OC, n=15). Blood samples were obtained preoperatively and on postoperative day 1 (24 h after surgery) and day 3 (72 h after surgery), and blood concentration of C-reactive protein (CRP), leukocyte subpopulations, as well as levels of tumor necrosis factor-α (TNF-α) ex vivo secretion by peripheral blood mononuclear cells (PBMCs) were measured in both groups. Results. Hospitalization was significantly shorter in the LC group than in the OC group (LC group: 3.7±1.2 days versus OC group: 6.3±2.7 days, p=0.010). There was no postoperative morbidity in the LC group, but two patients in the OC group had postoperative complications. Postoperative TNF-α ex vivo secretion by PBMCs and PBMC counts in the OC group were significantly lower than those in the LC group (p=0.002). The CRP level declined by postoperative day 3, but was significantly less in the OC group than in the LC group (p<0.001). Postoperative monocyte counts significantly decreased in the OC group compared with those in the LC group (p=0.001). Conclusions. A laparoscopic approach appears to cause less surgical trauma and immunosuppression than open surgery in patients with acute cholecystitis.

Original languageEnglish
Pages (from-to)207-214
Number of pages8
JournalScandinavian Journal of Clinical and Laboratory Investigation
Volume67
Issue number2
DOIs
Publication statusPublished - 2007 Mar 19

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Acute Cholecystitis
Laparoscopic Cholecystectomy
Blood
Surgery
Prospective Studies
C-Reactive Protein
Blood Cells
Wounds and Injuries
Tumor Necrosis Factor-alpha
Blood Cell Count
Cholecystectomy
Ambulatory Surgical Procedures
Laparoscopy
Immunosuppression
Monocytes
Hospitalization
Leukocytes
Inflammation
Morbidity

Keywords

  • Acute cholecystitis
  • Immunosuppression
  • Laparoscopic cholecystectomy
  • TNF-α

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

@article{f6d5e827a0364b38b0024f269d02eb57,
title = "Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis: A prospective randomized study",
abstract = "Objective. Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of this study is to evaluate the influence of surgical trauma on systemic inflammation and the immune response in acute cholecystitis. Material and methods. Thirty-three patients with acute calculous cholecystitis were assigned to laparoscopic cholecystectomy (LC, n=18) or open cholecystectomy (OC, n=15). Blood samples were obtained preoperatively and on postoperative day 1 (24 h after surgery) and day 3 (72 h after surgery), and blood concentration of C-reactive protein (CRP), leukocyte subpopulations, as well as levels of tumor necrosis factor-α (TNF-α) ex vivo secretion by peripheral blood mononuclear cells (PBMCs) were measured in both groups. Results. Hospitalization was significantly shorter in the LC group than in the OC group (LC group: 3.7±1.2 days versus OC group: 6.3±2.7 days, p=0.010). There was no postoperative morbidity in the LC group, but two patients in the OC group had postoperative complications. Postoperative TNF-α ex vivo secretion by PBMCs and PBMC counts in the OC group were significantly lower than those in the LC group (p=0.002). The CRP level declined by postoperative day 3, but was significantly less in the OC group than in the LC group (p<0.001). Postoperative monocyte counts significantly decreased in the OC group compared with those in the LC group (p=0.001). Conclusions. A laparoscopic approach appears to cause less surgical trauma and immunosuppression than open surgery in patients with acute cholecystitis.",
keywords = "Acute cholecystitis, Immunosuppression, Laparoscopic cholecystectomy, TNF-α",
author = "Yoon-Jung Boo and Wan-Bae Kim and Kim, {Jong Han} and Taejin Song and Choi, {S. Y.} and Kim, {Y. C.} and Suh, {S. O.}",
year = "2007",
month = "3",
day = "19",
doi = "10.1080/00365510601011585",
language = "English",
volume = "67",
pages = "207--214",
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TY - JOUR

T1 - Systemic immune response after open versus laparoscopic cholecystectomy in acute cholecystitis

T2 - A prospective randomized study

AU - Boo, Yoon-Jung

AU - Kim, Wan-Bae

AU - Kim, Jong Han

AU - Song, Taejin

AU - Choi, S. Y.

AU - Kim, Y. C.

AU - Suh, S. O.

PY - 2007/3/19

Y1 - 2007/3/19

N2 - Objective. Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of this study is to evaluate the influence of surgical trauma on systemic inflammation and the immune response in acute cholecystitis. Material and methods. Thirty-three patients with acute calculous cholecystitis were assigned to laparoscopic cholecystectomy (LC, n=18) or open cholecystectomy (OC, n=15). Blood samples were obtained preoperatively and on postoperative day 1 (24 h after surgery) and day 3 (72 h after surgery), and blood concentration of C-reactive protein (CRP), leukocyte subpopulations, as well as levels of tumor necrosis factor-α (TNF-α) ex vivo secretion by peripheral blood mononuclear cells (PBMCs) were measured in both groups. Results. Hospitalization was significantly shorter in the LC group than in the OC group (LC group: 3.7±1.2 days versus OC group: 6.3±2.7 days, p=0.010). There was no postoperative morbidity in the LC group, but two patients in the OC group had postoperative complications. Postoperative TNF-α ex vivo secretion by PBMCs and PBMC counts in the OC group were significantly lower than those in the LC group (p=0.002). The CRP level declined by postoperative day 3, but was significantly less in the OC group than in the LC group (p<0.001). Postoperative monocyte counts significantly decreased in the OC group compared with those in the LC group (p=0.001). Conclusions. A laparoscopic approach appears to cause less surgical trauma and immunosuppression than open surgery in patients with acute cholecystitis.

AB - Objective. Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of this study is to evaluate the influence of surgical trauma on systemic inflammation and the immune response in acute cholecystitis. Material and methods. Thirty-three patients with acute calculous cholecystitis were assigned to laparoscopic cholecystectomy (LC, n=18) or open cholecystectomy (OC, n=15). Blood samples were obtained preoperatively and on postoperative day 1 (24 h after surgery) and day 3 (72 h after surgery), and blood concentration of C-reactive protein (CRP), leukocyte subpopulations, as well as levels of tumor necrosis factor-α (TNF-α) ex vivo secretion by peripheral blood mononuclear cells (PBMCs) were measured in both groups. Results. Hospitalization was significantly shorter in the LC group than in the OC group (LC group: 3.7±1.2 days versus OC group: 6.3±2.7 days, p=0.010). There was no postoperative morbidity in the LC group, but two patients in the OC group had postoperative complications. Postoperative TNF-α ex vivo secretion by PBMCs and PBMC counts in the OC group were significantly lower than those in the LC group (p=0.002). The CRP level declined by postoperative day 3, but was significantly less in the OC group than in the LC group (p<0.001). Postoperative monocyte counts significantly decreased in the OC group compared with those in the LC group (p=0.001). Conclusions. A laparoscopic approach appears to cause less surgical trauma and immunosuppression than open surgery in patients with acute cholecystitis.

KW - Acute cholecystitis

KW - Immunosuppression

KW - Laparoscopic cholecystectomy

KW - TNF-α

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VL - 67

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EP - 214

JO - Scandinavian Journal of Clinical and Laboratory Investigation

JF - Scandinavian Journal of Clinical and Laboratory Investigation

SN - 0036-5513

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